Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

Covers FDA‑approved hypoglossal nerve stimulation for adults ≥22 with moderate‑to‑severe OSA (AHI 15–65) who have BMI <35, predominantly obstructive events (<25% central/mixed), a PSG within 24 months, documented CPAP failure/intolerance, and DISE showing absence of complete concentric collapse and no other anatomic contraindications; excludes non‑FDA indications and patients with contraindications (e.g., BMI ≥35, hypoglossal palsy, significant cardiac/pulmonary disease, neuromuscular disease, pregnancy, MRI‑incompatible device needs, central/mixed apneas >25%, or inability to operate the device). Key requirements: manufacturer‑validated DISE interpretation and implanting‑surgeon/provider training, and documentation of PSG, AHI, BMI, age, CPAP failure/intolerance with shared decision‑making, DISE report, operative/device records, and proof the patient can operate the sleep remote—lack of required certification/validation may be grounds for non‑coverage.